September 9, 2015 - Acute Diarrhea

Question 1

Acute Diarrhea

Answer 1

Less than 3 weeks in duration.

Question 2

Chronic Diarrhea

Answer 2

Greater than 3 months.

Question 3

Bloody vs Non-Bloody Diarrhea

Answer 3

The #1 most important question to ask. Narrows down the differential.

Question 4

Bloody Diarrhea

Answer 4

Commonly caused by…

• Campylobacter*
• E. coli 0157*
• Salmonella*
• Shigella*
• Yersinia*
• C. difficile* (sometimes)

Question 5

Indications for Antibiotic Treatment of Diarrhea

Answer 5

• C. difficile
• At the extremes of age. This can kill old people, and in young children it can be bad if E. coli is present.
• “Toxic” patient

Question 6

Oral Rehydration

Answer 6

Sugar and salt in the proper concentration. Even if everything else is screwed up in the gut, the glucose / Na⁺ channel will still work and you will be able to rehydrate your body.

Question 7

Clostridium difficile

Answer 7

Anaerobic, gram-positive bacilli of the clostridium genus.

Spore forming bacteria. This is important because it is hard to completely get rid of.

5-15% of healthy adults carry C. difficile.

Question 8

Treatment of CDI

Answer 8

Empiric treatment if high index of suspicion.

For mild-moderate disease, treat with metronidazole.

For severe disease, use vancomycin.

If recurrence, pulse vancomycin. If it recurs again, then you need to use a fecal transplant which is very successful.

Question 9

Borborygami

Answer 9

Very loud rumbling sounds of the stomach.

Question 10

Approach to Chronic Diarrhea

Answer 10

Question 11

Malabsorption of Fat Causes

Answer 11

Issues with…

1. Bowel
2. Pancreas
3. Bile